In medical practise, whether for purposes of examination or surgical procedures, the devices used in the practice must allow for the surgeon to easily interact with the patient's organs and cavities. Devices cumbersome to handle or manipulate may result in unsuccessful surgical procedures, misdiagnoses and, particularly in the case where the patient is not anaesthetised, great discomfort to the patient.
UK 2 284 158 discloses an injection catheter consisting of an outer sheath and a needle means located in and axially movable with relation to the outer sheath. Thus, when performing multiple injections, retraction of the needle means and rotation of the outer sheath is required. Moreover, the device does not allow for visualisation during the medical procedure.
WO 99/47069 discloses an instrument for guiding delivery of an injectable material for treating urinary incontinence. The device does not allow for variable positions of injection nor for visualisation during the medical procedure.
U.S. Pat. No. 5,020,514 discloses an endoscope for nasal surgery. Said endoscope comprises an outer shaft with a handle incorporating a switching valve for connecting/disconnecting a source of negative pressure and a source of a flushing fluid. A working insert, for insertion into the outer shaft, comprising a shaft for receiving an optical system, proximally connected to the working insert, a shaft for receiving an auxiliary instrument, and two guides for wires and rods, which are movable by means of handles.
U.S. Pat. No. 5,287,845 describes an endoscope for transurethral surgery, which has a main body irrotationally supporting an optic and a surgical instrument, an outer tube affixed to the main body and tubularly enclosing the optics and the surgical instrument. The outer tube is rotational relative to the remaining endoscope parts.
DE 42 37 850 discloses a device and method for injection/application of a fluid/medicament carrier, such as polyacrylamide, for medical use.
Further devices representative of the state of the prior art are described in WO 94/28782, U.S. Pat. No. 4,877,033, U.S. Pat. No. 5,313,934, and U.S. Pat. No. 5,320,091.
There is a need in the art for a device which, when attached to an optical device, allows for manipulation of the working element, namely the elements contacting with the patient, whilst allowing other elements, typically connected to fixed units in the operating theatre, to remain immobile. This allows for the surgeon to simply manipulate the working element whilst at once being visually aware of the interaction between the element inserted into the patient with the patient and being free from other cumbersome attachments.